Rewiring Is a Thing Now

Rewiring is a thing now. Medicine, don't hide it!

"I keep saying my case is weird. My body is still in a coma n my head is awake." I put this on a social network when I became Medicaid Waiver. Medicaid Waiver is a program set aside for the very ill. It is designed to keep a person in the community and out of the hospital.

People don't think of me as being ill. I don't have a head cold. I have a g-tube, or it is also called a feeding tube. The device isn't so scary to the community anymore, but it is serious. It is pretty much an IV that delivers its contents to the stomach and not the bloodstream.

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" Angela Ronson your body is not in a coma. Neither is your brain," Trudy Martinez. She is an Occupational Therapist.

"I would say that, technically, at this time you are a traumatic brain injury (TBI) with residual quadriparesis," Trudy Martinez. 

I've been hearing for years that a person continues to make progress after a brain injury, but no one has outright said that my diagnosis was "residual." THAT fits. I was thinking about making up the word "de-paralyzing," because my body is becoming less paralyzed.

"Angela Ronson - I was told in rehab that recovery shouldn't be looked upon as a final destination, as recovery is ongoing and lifelong. It is a journey, and that medicine, as a whole, tends to look at everything as a finality (here anyway). The words 'cure' and 'heal' are never used in that facility because they do not mean the same thing in a brain injury standpoint; so I don't use them," Lisa Rice

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It comes down to 'why so long?' You will find that there were small progressive steps along the way. I believe the progression coincides with the growth of small nodules discovered years earlier.

I've said it before. I've quoted this.

"Their quantification of white matter reorganization shows long-distance rewiring in posterior medial cortices, possibly reflecting axonal sprouting or neurite outgrowth, maybe even related to neurogenesis " happens to be Steven Laureys describing a man who was MCS, but started talking nearly 20 years later. What he is saying is that tiny nerve fibers grew and rewired. This is most likely going on with me. http://thoughtfulveg.blogspot.com/2017/08/not-fast-enough.html

Growth does not happen overnight. ( https://thoughtfulveg.blogspot.com/2018/08/neurogenesis-is-proces
s.html )

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RESIDUAL QUADRIPARESIS- I like that word, "residual." It goes with rewiring and explains slow gradual growth.

The concept of rewiring, neuroplasticity, is so common now. I don't think it is accepted yet.

My Late Recovery

The brain cell may be gone forever, but the action isn't. (This may be a fictitious statement, but it is a culmination of what was taught and experience.)

 

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Excuse me, but I used to be quadriplegic.  I would think that being able to use both hands again after 15 years qualifies as improvement. Talking wasn't good enough for the government program I was in. The doctor couldn't understand me.

Sorry I can't swallow. That is called dysphagia. A stroke can rob swallowing and that's what happened here. An inability to swallow does not mean I'm not conscious or in a coma.

Maybe that's why there aren't any recoveries here. The government seems hellbent on keeping me vegetative. Where was the investigation?

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Those late recoveries... Did it ever occur that neurogenesis is happening with neuroplasticity in these cases? I bet it is very rare. This is what it looked like to me.

Neuroplasticty is rewiring. Most have heard of rewiring the brain, but what is neurogenesis?

 

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 How many 2-month periods have I had

in the last 15 years?

I bet I'm producing more than one neuron each time. 

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2/17/2018

"The brain cell may be gone forever, but the action isn't" probably means a different cell is now doing the moving. If not, I am making ghostly movements. So neuroplasticity occurred. Since there were no other cells available, neurogenesis would also have had to occur. If not, these are ghostly movements and you are dealing with the supernatural.

Not Fast Enough

That I am not "vegetative" anything is a big deal. What I have hasn't been a recoverable condition.

http://thoughtfulveg.blogspot.com/2016/10/disabled-or-idiot.html

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"Their quantification of white matter reorganization shows long-distance rewiring in posterior medial cortices, possibly reflecting axonal sprouting or neurite outgrowth, maybe even related to neurogenesis " happens to be Steven Laureys describing a man who was MCS, but started talking nearly 20 years later. What he is saying is that tiny nerve fibers grew and rewired. This is most likely going on with me.

Now given my capacity for increased growth, this will happen fast in me. How fast is fast?

The above quote is based on a case that took about 20 years. 10 years for me sounds feasible.

That's half the time and can be seen as a huge increase. It is still years, though. It isn't readily picked up on. A form comes once a year in the mail asking if there have been any changes in the last 12 months. The answer is no. If it had asked if there were any changes in the last 10 years, the answer would be yes.

It isn't "Abracadabra, You are all better." This has been a process. Sure, I don't swallow yet, but what vegetative person can type all this out? I'm sorry that I'm not fast enough for you. (While I'm at it, how about some therapy for swallowing? It's called Speech. People are amazed that I talk without swallowing. I think I am articulating my vocalizations very well.)

What people want:

What people got:

PICTURES
https://www.flickr.com/photos/angelar70/albums/72157625839268830

What I believe that increased the recovery time will have to become an accepted condition (Savant Syndrome). This can then be studied. New medications and treatments can be developed for brain injury as well as other neurological diseases.

Is it too good to be true?

Excuse me, but I used to be blind in my right eye and now I'm not, and nobody sees that as a big deal?

I've thought it was rewiring mainly, but I recently read that an over-the-counter eye medication is reversing the damage caused by MS. Could this be the same thing happening with brain injury? Eye drops or my body...both should be looked at.

I looked closer at the article, https://www.sciencedaily.com/releases/2016/04/160412211123.htm 

"A common antihistamine used to treat symptoms of allergies and the common cold, called clemastine fumarate, partially reversed damage to the visual system in people with multiple sclerosis (MS) in a preliminary study." What brand is it in? Tavist came up.

I take a different medication. I use Naphcon-A eye drops. They are both allergy medications. At home, I will put the eye drops in as soon as I get a burning sensation in my eye. The burning stops immediately. To note, my eye may have already been closed for an extended time. It would not be dry eye. Long ago, when Naphon-A became OTC, my doctor said it was a "vasoconstrictor." It works by narrowing the blood vessels in the eye. I'm pretty sure what got me here was vascular. I had an AVM (arteriovenos malformation) bleed. I know, "'had." That's past tense. It's now gone. Isn't it a vascular problem? Blood vessel dilation and constriction is also vascular. There may be correlation here.

I do know I see now with both eyes. I may not be legally blind anymore. I would still be low vision, probably. Testing is not covered.

NOTE:  This medication has been recalled and banned due to other problems.  11/21/2016

Symptoms Not Characteristics

" I need a lot more rest than I used to. I’m not being lazy. I get physical fatigue as well as a “brain fatigue.” It is very difficult and tiring for my brain to think, process, and organize. Fatigue makes it even harder to think.
My stamina fluctuates, even though I may look good or “all better” on the outside."  http://braininjuryknow.blogspot.com/2015/08/i-need.html

This sounds like rewirlng. It also sounds like a lot of brain injuries.

The brain uses energy. "It is well established that the brain uses more energy than any other human organ, accounting for up to 20 percent of the body's total haul." http://www.scientificamerican.com/article/why-does-the-brain-need-s/

Take away that energy, or put it somewhere else, of course one

will get tired. Fatigue can be a symptom of brain loss or rewiring. It is not safe to assume it is due only to brain loss.

"My stamina fluctuates" is my Socially Awkward Penguin's comment. (He really is called "The Socially Awkward Penguin".)

As the skill is repeatedly performed, the neuropathway gets stronger. "In order for the brain to rewire an activity, the activity must be done repeatedly. Norman Doidge gives a description of this when he likens it to snow skiing, but uses it to explain a bad habit. "Plasticity is like snow on a hill in winter. If we want to ski down the hill we can take many different paths because the snow is so pliable and plastic. But being human we tend to favour one path and pretty soon we´ve developed a grooved track, which ultimately becomes a rut that is hard to get out of." http://thoughtfulveg.blogspot.com/2013/03/groove-me.html  This process of rewiring can take a long time. This process can also be called neuroplasticity.

It can be completed when this new neuropathway is used. The body has to be trained to use it. 

This video shows two neuropathways.The top one is the old damaged way. The bottom is the new  one that works. On days you can do your task, you are using the new neuropathway, or bottom. When you can't, it's the old.
 

These two "characteristics" of brain injury (fatigue and doing/not doing ability) can be "symptoms" of rewiring. This process can take a very long time. It can take years, and a lucky survivor of brain injury won't take as long. "Something" is going on and it should be tracked. Self-report in the form of a yes/no question on a social security form is not enough. (Obviously, if I am still vegetative.)

"So, come up to the lab,/ and see what's on the slab!/ I see you shiver with antici... [3-second long pause] ...pation./ But maybe the rain/ isn't really to blame,/ so I'll remove the cause.../ [chuckles] but not the symptom." The Rocky Horror Picture Show

A Tale of Two Pictures

The pictures are exactly one year apart. I was updating a community of followers, but someone made a comment about neuroplasticity. I compared the two pictures. Yes, it was blatant. It can be seen in the two pictures.

Neuroplasticity: The brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.  http://www.medicinenet.com/script/main/art.asp?articlekey=40362

Neuroplasticity is also called rewiring.

Now how is it so blatant in the two photographs? Look at the first picture. The original post was about my hair. My face was of no concern. Today we're looking at my face. The second picture is a year later. I was just showing the change. People will think that I am happier.

 

The other corner of my mouth comes up. I have a definitive smile--line around my mouth. My face doesn't droop.

It can't be said that I am happier. I can't get away with jokes or antics. Maybe, it is that you are happier.

Hand Development



Less than a year ago I could press a button with my paralyzed hand. I documented it with a picture. http://thoughtfulveg.blogspot.com/2014/08/my-parralyzed-hand.html Now I do more, and I document it with a video.
  



Certain signs are hard for me to do because some fingers are still wired together, neurons that fire together wire together,  http://thoughtfulveg.blogspot.com/2014/11/neurons-that-fire-together-wire-together.html For example, my pinky is wired to my ring finger. When I make the 'W' sign (three fingers up) I have to use my other hand to hold my pinky down. Wiring together is temporary. As further wiring occurs, fingers individuate.

For the most part, my ring finger and middle finger aren't wired together anymore. Finger individuation is possible. Any difficulties I refer to an OT. The Occupational Therapist can work on next skills to be learned.
 

This next picture clearly shows my right hand as fisted. My fingers were wired together.
 



My fingers didn't stay wired together, but there is a great deal of time from the first picture to the video.

I make progression, but it is slow. I am still unconscious on paper, and this should be updated.

Learning: Making A Neural Pathway Part II

In writing this http://thoughtfulveg.blogspot.com/2011/04/making-neuropathway.html I was looking for an answer to why some people recover faster after a brain injury than other people. I believe the answer is neural pathways available.

Rewiring (quickly) seems to mostly happen in the first year (it's not over there. so don't worry). Existing neural pathways are recruited. This accounts for those people who seem to recover quick.

Then there is long-term rewiring, This can feel like forever to a person. The neural pathway doesn't exist. So the brain makes one.

This process is similar to learning, if not the same. http://en.wikipedia.org/wiki/Learning

 

I'm not recovering fast. I'm learning fast.



Plateaus Are Imaginary

"Two steps forward" is progression. A "step back" is a lull in development.

Long ago in my Master's training program, there was a guest lecturer. She was a therapist. She said when you reach a stall in development, a plateau, you work through it. Now this was a program for early intervention in special education. I didn't know the practice in some physical therapy was to stop if there was a lull in attaining developmental skills. Special education teachers can be working with the same student for years. There may be lulls in the student's development, but that's what makes it "special." A teacher doesn't quit working with a student because he or she doesn't learn.

Although development is slow, the student "gets it" eventually, sometimes years later (the particular task worked on). Gosh, there probably was a lull at that moment in time when started, but it wasn't forever. The same can happen in brain injury. Prime example...me. My developmental skill progression was slow. Sure I had a lull in development at the beginning of my brain injury. "No Progress" is determined. I was placed with the vegetative. That is how I remain today.

Years later I am writing this. It wasn't "Wham! She can write." It's taken many years and I use accessibility features on the computer. I was published in 2009, http://www.nxtbook.com/nxtbooks/aha/strokeconnection_20090708/index.php#/10/OnePage. My accident  was in 2002. There's just a lull right there in dates. I don't know of any rehab that lasts 9 years. A special ed teacher would last that long, though, and that is what I used to do. That's what I did when therapy ran out. No therapist showed me how to type. Accessibility is an area I used to cover. I've just applied techniques to myself.

Let's see what this document says http://braininjuryknow.blogspot.com/2013/04/getting-there.html. I directly quote an article,

"The nerve fibers from the cells were severed, but the cells themselves remained intact." Nerve cells that have not died can form new connections. It goes on to say, "The new research suggests that instead of the sudden recovery Wallis seemed to make when he began speaking and moving three years ago, he actually may have been slowly recovering all along, as nerves in his brain formed new connections at a glacial pace until enough were present to make a network."  http://usatoday30.usatoday.com/news/health/2006-07-03-brain-rewired_x.htm        

This thing was written a few years ago. How can anyone without that proper equipment determine there will be "No Progress"? A person would have to be able to see "nerve fibers from the cells." My eyes aren't that good, so I can't. From the way it read, this wasn't a regular MRI either. This was a few years ago, so I'm sure the technology is more widely available now. Still, though, to the naked eye, progress can't be determined.

I go on to reassure that rewiring can't be seen and may take years. With this research available then, why is it that people are still being told there will be no progress? The "plateau" isn't really there.

Intensive Brain Remaking.

I was fascinated with the story of Pedro when I read about it in Norman Doidge's book, The Brain That Changes Itself. Pedro was the father of a famous neuroscientist. I saw the same story in another blog. Somebody else found it fascinating.

From http://www.brainbequick.com/brain-plasticity-miracle.html

Pedro Rewired His Brain After a Massive Stroke

In his book, The Brain That Changes Itself, Norman Doidge, M.D. relates the brain plasticity miracle of Pedro.
  

At the age of sixty-five, Pedro Bach-y-Rita had suffered a massive stroke that paralyzed his face and half of his body.
 

He was unable to talk or walk, and his sons Paul and George were told there was no hope for recovery,” and that Pedro would have to go into an institution.
 

Dr. Paul Bach-y-Rita was a neuroscientist and rehabilitation physician, and also a pioneer in promoting the understanding that the human brain has an amazing ability to adapt and change itself; what we now know as brain plasticity.     
 

At first George, then a medical student in Mexico, arranged rehabilitation for his father at a local hospital, which offered a typical four-week therapy.
 

Pedro showed very little progress, and George decided to have him come and live with him so he could provide additional therapy.
 

He knew nothing about rehabilitation, and his ignorance turned out to be a blessing. He succeeded by breaking all of the current rules.

“I decided that instead of teaching my father to walk, I was going to teach him first to crawl” George said. “I told my father, ‘You started off crawling. You are going to have to crawl again for a while.’ The only model I had was how babies learn.”

As soon as Pedro could support himself, George had him crawl with his weak shoulder and arm supported by a wall.
 

Pedro loved gardening, and Paul had him practicing outside, which led to problems with the neighbors who thought it was unseemly to make the professor crawl like a dog.
 

It took many hours each day, but gradually Pedro went from crawling to moving on his knees to standing and finally to walking.
 

Pedro struggled with speech on his own, and after three months it began coming back.
 

He learned to type normally and at the end of a year he was able to return to full-time teaching at City College in New York.
 

Pedro was active for seven more years until, while climbing in the Colombia Mountains, he suffered a heart attack.
 

Dr. Paul Bach-y-Rita later discovered that 97% of the nerves that ran from the brain’s cerebral cortex to the spine had been destroyed by the stroke.
 

Pedro's brain had totally reorganized itself as a result of the intensive “brain remaking.”

 

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It would make sense that this is what I am doing, "intensive brain remaking". My  brain is just restructuring. It's just massive brain remaking. (There was SOME brain, even if it was so little I had "even less brain functioning [than] that would suffice to maintain the live functions of a quite primitive reptile." I like how that was said. Others have said it was so little I was a "vegetable.") Although it looks miraculous now,  there's nothing miraculous going on.  Everything right now can be explained.

A miracle could have happened long ago when I was unconscious. That's then. This is now.

During my recovery I compared the brain to Silly Putty, http://braininjuryknow.blogspot.com/2011/03/wonders-of-silly-putty.html. I was once told the brain was like clay, but to me the brain is more special than that. Silly Putty is like special clay. Also, like clay, it could be missing some and still do the same things. "But it can still be molded, shaped, played with, and retain most, maybe all, of its properties." My Silly Putty is just changing.
  
 

I'm just changing my brain- neuroplasticity or rewiring.